Effect of asphyxia on the pupils of brain dead subjects

Larson, Merlín D.; May, Jacqueline

doi:10.1016/s0300-9572(02)00195-8

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…The pupus often duate following cardiac arrest; however, the mechanism is not completely understood. It is commonly presumed that, during CPR, the functions of pupiUoconstrictor cells and the sympathetic nervous system would be impaired because of inadequate tissue perfusion in critical midbrain sites (26). Dilation of pupils may also be linked to ineffective chest compression.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Cardiopulmonary Resuscitation for Patients With Out-of-Hospital Cardiac Arrest of Cardiac Origin

Maekawa

Tanno

Hase

et al. 2013

Critical Care Medicine

333

265

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Section: Discussionmentioning

confidence: 99%

Extracorporeal Cardiopulmonary Resuscitation for Patients With Out-of-Hospital Cardiac Arrest of Cardiac Origin

Maekawa

Tanno

Hase

et al. 2013

Critical Care Medicine

333

265

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“…Patients who receive “confounding medications” such as epinephrine or atropine are frequently excluded from analysis despite lack of evidence to suggest that either interferes with PLR when administered systemically. 3 –7…”

Section: Introductionmentioning

confidence: 99%

“…Patients who receive "confounding medications" such as epinephrine or atropine are frequently excluded from analysis despite lack of evidence to suggest that either interferes with PLR when administered systemically. [3][4][5][6][7] Pupil dilatation and constriction are mediated by interplay between the sympathetic and parasympathetic autonomic nervous systems. Topical application of sympathomimetic drugs directly stimulates musculus dilator pupillae, which dilates the pupil, and topical parasympatholytic drugs cause mydriasis and abolish the light reflex.…”

Section: Introductionmentioning

confidence: 99%

Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation

Achamallah

Fried

Love

et al. 2020

J Intensive Care Med

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Introduction: Absence of pupillary light reflex (PLR) is a well-studied indicator of poor neurologic recovery after cardiac arrest. Interpretation of absent PLR is difficult in patients with hypothermia or hypotension, or who have electrolyte or acid-base disturbances. Additionally, many studies exclude patients who receive epinephrine or atropine from their analysis on the basis that these drugs are thought to abolish the PLR. This observational cohort study assessed for presence or absence of PLR in in-hospital cardiac arrest patients who received epinephrine with or without atropine during advanced cardiac life support and achieved return of spontaneous circulation (ROSC). Methods: Pupil size and reactivity were assessed in adult patients who had an in-hospital cardiac arrest, received epinephrine with or without atropine, and achieved ROSC. Measurements were taken using a NeurOptics NPi-200 infrared pupillometer. Results: Forty patients had pupillometry performed within 1 hour (median: 6 minutes) after ROSC. Of these only 1 (2.5%) patient had nonreactive pupils at first measurement after ROSC. The remaining 39 (97.5%) had reactive pupils. Of the 19 patients who had pupils checked within 3 minutes of ROSC, 100% had reactive pupils. Degree of pupil responsiveness was not correlated with cumulative dose of epinephrine. Ten patients received atropine in addition to epinephrine, including the sole patient with nonreactive pupils. The remaining 9 (90%) had reactive pupils. Conclusion: Epinephrine and atropine do not abolish the PLR in patients who achieve ROSC after in-hospital cardiac arrest. Lack of pupillary response in the post-arrest patient should not be attributed to these drugs.

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Automated pupillometry helps monitor the efficacy of cardiopulmonary resuscitation and predict return of spontaneous circulation

Shi

Wang³

et al. 2021

The American Journal of Emergency Medicine

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Effect of asphyxia on the pupils of brain dead subjects

Cited by 6 publications

References 16 publications

Extracorporeal Cardiopulmonary Resuscitation for Patients With Out-of-Hospital Cardiac Arrest of Cardiac Origin

Extracorporeal Cardiopulmonary Resuscitation for Patients With Out-of-Hospital Cardiac Arrest of Cardiac Origin

Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation

Automated pupillometry helps monitor the efficacy of cardiopulmonary resuscitation and predict return of spontaneous circulation

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